When to Seek Professional Help

Angela Oswalt Morelli , MSW

Children's normal pubescent experimentation with new friends, activities, physical appearances, and ideas is not always consequence-free. In striving to push beyond previous limitations, children sometimes push too far, and find themselves engaging in dangerous or unsafe behavior. Parents may not become aware of their children's difficulty until problems have become severe. In such cases, parents may wish to get support and guidance from professionals, such as family doctors, and behavioral health specialists including social workers, counselors and psychologists, who specialize in helping families cope with adolescent distress and illness.

It's not always clear to parents when children's experiments have taken them into unsafe territory, resulting in their development of significant and overwhelming problems. Below we describe some common problem areas that signal that a serious issue may be occurring which might benefit from professional help.

Drugs and Alcohol

By puberty, some children will have started to experiment with alcohol and drugs (such as marijuana). While certainly not optimal, children's experimental and transient use of such substances is not necessarily cause for panic. In such cases, parents should teach children why such substances are harmful, express genuine concern for their welfare, and provide disciplinary consequences for substance use. Often, this approach combined with continued parental vigilance will be sufficient limit setting to set children back on track.

Parents should recognize their children as having a serious substance abuse problem if they become aware that their child is using drugs and/or alcohol on a regular basis despite receiving parental discipline and warning that this is unacceptable, unsafe behavior. Any evidence that a child's substance use has negatively impacted their school work or other activities, their mood or emotional stability, their personal safety, or their important social and family relationships should only amplify parent's concern, as should any indication that new or additional kinds of drugs are being used.

Violence and Abuse

Parents should take seriously any suggestion that their children are involved in and cannot remove themselves from violent, abusive or obsessive relationships. Children's participation in such relationships may take various forms, the most easily recognizable of which is when a child becomes a victim of physical or sexual abuse. However, parents should be alert to the possibility that their child may become abusive and aggressive towards other children, such as is the case when a child bullies other children. Parental loyalty towards their children is very strong, as is parents' desire to believe that all is well with their children. It can be quite difficult to recognize your own child as a bully or a victim of bullying; as a victim or perpetrator of physical or sexual violence in the context of a pubescent relationship; or the recipient of unwanted attention from an obsessive "stalker". However, these potentially serious situations do indeed occur and may merit professional consultation.

Disciplinary Problems

Parents should consider consulting with a child psychologist or similar behavioral counselor in the event that their children repeatedly break house rules, or put themselves in risky or unsafe situations, despite parents' previous attempts to discipline them.

Unexplained Mood or Behavior Changes

Children who show pronounced or exaggerated mood change, such as marked sadness, increased irritability or aggression, frequent tearfulness, or significant worry or anxiety, any of which lasts for a week or more, and which do not appear to be appropriate reactions to sad or worrying events, may be developing a mental health condition such as depression which would benefit from professional diagnosis and treatment. Similarly, changes in children's appetite, sleeping patterns, socialization, or motivation at school may also indicate that potentially serious problem are occurring that should be checked out. Please see our Child Mental Health Disorders topic center for more information.

Sometimes children's mood changes are very appropriate to circumstance, but are nevertheless very disturbing for children and their parents to cope with. This may occur in times of grief, when a child has lost a relative or a friend. Pronounced or painful grief situations may also benefit from professional consultation.